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The dreaded prostate cancer diagnosis.


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2023 Jan 4, 4:41am   402 views  6 comments

by Al_Sharpton_for_President   ➕follow (6)   💰tip   ignore  

My brother-in-law dropped a bombshell on the family several weeks back - he was diagnosed with prostate cancer. He is 66, in great shape. He still runs, does weights, and hikes a ton. I used to hang with him when I lived in WA state, and had a great time hiking around the Cascades and Olympics with him.

As I have worked in developing products for treating hematologic cancers, he and my sister asked me to look into prostate cancer prognosis and treatment options. Of course, they are reaching out to several MD's to discuss.

Here is what I found.

PC is staged based on several factors. A rising PSA level and the absolute value of serum PSA (i.e., 10-20 ng/mL) bumps you up as does greater that 20 ng/mL.

If you have low-level disease, a Gleason score of 3+3, you are prescribed no treatment, just watching and waiting. He is 3+4 and 3+3, and so treatment is recommended.

Besides the rate of change in PSA levels and absolute values, imaging is used for diagnosis. MRI with contrast media, and then if positive, what is called an MRI fusion biopsy where they fuse the MRI resutls with ive ultrasound as they take 12 biopsies, but under imaging guidance so it is pretty accurate at zeroing in on the funky prostate cancer cells.

This confirmed PC and established the Gleason score. So now he needs treatment and is freaking out that he will be life-long incontinent and impotent, especially if he undergoes surgery, radical prostatectomy. He is leaning towards getiing proton beam therapy, as Fred Hutch offers it, and it is reputed to have less side-effects. it takes longer, one month plus, whereas with surgery, you stay one night in the hospital, and then are discharged, with a catheter, as they have to sever the urethra from the bladder, which usually grows back (ouch!).

I continue to research treatment study results, but they are not usually from randomized clinical trials, and what is reported retrospectively is from a wide range of Gleason scores and general health, but what seems to be believed is that surgery and radiation therapy (there are several types) have equivalent 10-year survival rates, which are actully pretty decent. And the claim is that compared to the other types of radiation therapy, proton beam is reputed to cause less damage to surrounding tissue as the protons do not pass through the prostate like X-rays, and hit what is behind the gland.

If anyone can share anecdotal experiences of relatives, friends, co-workers, that would be appreciated.

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1   clambo   2023 Jan 4, 6:41am  

A friend of mine had it.
I guess it was 20 years ago or so.
He had surgery and had an Rx for Viagra. I don't recall details of his treatment but I guess it was the traditional surgery.
He's still alive since I see him on Facebook sometimes.
2   PeopleUnited   2023 Jan 4, 7:24am  

I know a gent who died of PC. It was brutal. Spent his last month or so in a hospital bed at home, unable to do basically anything for himself.
3   RedStar   2023 Jan 4, 7:57am  

The problem with surgery is likelihood of complications. The problem with not doing surgery is a painful death as prostate cancer typically metastasizes into the bones.
4   Patrick   2023 Jan 4, 8:10am  

The VP in my group at Schwab announced he had PC about 20 years ago. He's still fine. My father-in-law announced he had PC about 5 years ago. He's still fine too. Wife's cousin had the radical prostatectomy a few years ago, but I haven't seen him in person since. He was at a family funeral recently and he looked OK on Zoom. (The funeral had a Zoom feed, which I guess is pretty normal these days.)

I've read that most old men have prostate cancer, but it's usually slow growing and so it's not necessary to do anything.
5   Ceffer   2023 Jan 4, 8:55am  

The Seventh Day Adventist Hospital at Loma Linda apparently has an outstanding focused beam treatment program of some kind. A guy who went with one of my wife's old friends went through it and swears by it. He screws around like a rabbit, so it apparently did not interfere with his functioning. I don't know about cost or coverage, but they treat men in groups who also support each other and become friends.

Another neighbor who went on 'watch and wait' is still watching and waiting over ten years later. Apparently pushing 80 and still in good health.

I guess if you make it to 70 or so without a positive diagnosis, your chances of getting it drop off quite a bit.
6   NuttBoxer   2023 Jan 4, 9:29am  

Not specific to prostate, but my Mom had cancer in her liver and intestines. She did have a section of small intestine removed, which has reduced her quality of life, as she likes hiking, but now can't be too far from a bathroom for too long. For the liver they did some type of targeted lasers or something, may have also removed a small section, but liver grows back.

What matters is why she no longer has it. Dietary change. Her and my Dad got very active in exercising for years before she was diagnosed. Not at the level of your BIL, but point being, exercise alone is not enough. You have to identify and eliminating sources of pollution, diet being the big one.

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